Correlation Between Neutrophil-Lymphocyte Ratio in Cerebrospinal Fluid and Glasgow Coma Scale in Traumatic Brain Injury

Traumatic brain injury (TBI) is a significant global health issue characterized by disrupted brain function due to external mechanical force. The Glasgow Coma Scale (GCS) remains the standard tool for assessing TBI severity. However, it faces limitations in certain clinical scenarios, such as patients under sedation. The neutrophil-lymphocyte ratio (NLR) in cerebrospinal fluid (CSF) is being explored as a potential objective marker for evaluating the severity of traumatic brain injury (TBI). This study analyzes the relationship between the NLR in CSF and GCS scores in patients with TBI. An observational analytic study employed a prospective design involving 15 TBI patients treated at Dr. Soetomo General Hospital. GCS scores and NLR values from both blood and CSF were measured on the day of admission (D0) and two days later (D2). The mean blood NLR was 11.28 ± 7.52, while the means of CSF NLR D0 and D2 were 0.349 ± 0.446 and 0.469 ± 0.985. The mean scores of GCS D0 and D2 were 7.87 ± 3.70 and 8.80 ± 4.11. A statistically significant negative correlation was observed between the CSF NLR D0 and the GCS D0 scores (p < 0.05, r = -0.706), indicating that higher NLR values in CSF are associated with lower GCS scores, and thus, greater TBI severity. There were no significant correlations observed between blood NLR on day 0 (D0) and GCS scores on day 0 (D0), nor between CSF NLR on day 2 (D2) and GCS scores on day 2 (D2). The NLR in CSF at the time of hospital admission can serve as an objective marker for assessing the TBI severity. This marker could be useful in clinical settings where GCS assessment is challenging.

Correlation Between Neutrophil-Lymphocyte Ratio in Cerebrospinal Fluid and Glasgow Coma Scale in Traumatic Brain Injury Keywords:

Traumatic Brain Injury , Glasgow coma scale , Neutrophil-Lymphocyte ratio , cerebrospinal fluid